India stood fourth among 194 countries in the number of measles cases registered between July 2018 and June 2019, according to the latest measles surveillance data released by the World Health Organization (WHO).
With 39,299 cases India bagged the fourth spot after Madagascar (150,976), Ukraine (84,394) and Philippines (45,847). However, India had the lowest measles incidence rate per million in the top 10 countries — 29.68.
However, this WHO update has a silver lining too. The number of measles cases has come down — 24,076 in 2019 (recorded between Jan and June 2019) from 69,391 in 2018.
In fact, a paper published earlier this year said elimination of deaths due to measles is possible in India. “The (vaccination) campaign averted up to 41,000–56,000 deaths during 2010–13, or 39-57 per cent of the expected deaths nationally,” read the paper.
Vaccination, the biggest challenge
Children under the age of one get infected by the virus the most in India as they have the highest incidence rate of 76.4 per million population, according to WHO. Moreover, this is the same age bracket that has received highest number of zero doses of measles vaccination between July 2018 and June 2019.
The second highest rate of incidence occurs in children in the age group of 1-4 years. This age bracket had received second highest number of zero doses of vaccination. The trend is almost similar for children between 5-9 years who have the third highest incidence.
WHO recommends two doses of measles vaccine to create immunity against the disease.
While India has increased its measles vaccination coverage, it remains far from achieving the WHO’s deadline of 95 per cent coverage till 2020, according to a paper authored by two paediatricians from Mumbai.
Long way to go
India has taken several initiatives to protect its children and has made significant progress in decreasing measles incidence and related mortality and morbidity, wrote the doctors.
“Although these efforts have helped protect millions of children from measles, India still accounts for a significant proportion (estimated to be over 36 per cent) of measles-related deaths in children,” read the paper.
The authors also point out in the paper that though India has 11 laboratories to test samples for measles, the number of confirmed cases remained only 12 per cent in 2015.
“Establishing laboratory networks faces shortage of human and financial resources. Once India accelerates its case detection and case-based surveillance systems, more serological samples will now be referred for laboratory confirmation of measles and will improve the much-needed surveillance,” wrote the paediatricians.
In fact, while the USA was battling one of its worse measles outbreak in May this year, a paper published in the Lancet counted India as one among the top seven countries that lead to the spread of the disease there.